Study on active ingredients of Jingfang Baidu San for preventing COVID-19 based on network pharmacology and molecular docking / 药学实践杂志

Objective To investigate the active ingredients of Jingfang Baidu San for the prevention and treatment of COVID-19 by using network pharmacology and molecular docking, and to provide references for clinical applications. Methods The chemical constituents and action targets of all medicinal materials in Jingfang Baidu San were retrieved from TCMSP. Uniprot database was used to search the corresponding genes of targets. Cytoscape software was used to construct the network of medicinal materials-compounds-targets for visualization. The target proteins of COVID-19 were searched by disease databases. The intersection of both was considered to be analyzed to establish the protein-protein interaction (PPI) network by STRING database. GO function enrichment analysis and KEGG pathway enrichment analysis were performed through Metascape database to predict its mechanism. The effective strength of core constituents on preventing COVID-19 was calculated by molecular docking method. Results A total of 159 effective ingredients and 277 potential targets were obtained in Jingfang Baidu San within the given screening conditions [oral bioavailability (OB) ≥30%; drug-like (DL) ≥ 0.18], including 55 core targets with the intersection of 273 targets of COVID-19. According to the results of GO and KEGG enrichment analysis performed on the core targets, 1376 GO items and 136 KEGG pathways were obtained, involving infectious diseases, cancer, cell progress, immune system, signaling pathways etc. The results of molecular docking indicated strong binding capacity between the core ingredients and SARS-CoV-2 3CL hydrolase or angiotensin-converting enzyme II (ACE2). The hydrogen binding and hydrophobic effect were the main forms of the interaction. Conclusion The active ingredients in Jingfang Baidu San can inhibit the binding between SARS-CoV-2 protein and ACE2, thus regulating multiple targets and signal pathways, which plays a role in the prevention and the treatment of COVID-19.

Aesthetic reconstruction of distal finger or middle-distal finger degment with transplantation of 2nd, 3rd or 4th toe / 中华显微外科杂志

@#Objective To report the results of aesthetic reconstruction of distal finger or middle-distal finger segment with transplant harvested from 2nd, 3rd or 4th toe. Methods In a series of 108 cases of distal finger or middle-distal finger segment defect, 141 fingers were reconstructed with transplants harvested from 2nd, 3rd or 4th toe according to the outward appearance of donor toe. The blood-supply was restored by anastomosis of digital artery and vein. In first-stage reconstruction, refinement of outward appearance was applied in doner toe if the toe pulp is bulky or middle part of toe was relatively thinner. Results One hundred and forty fingers survived. The successful rate was 99.3%. Among them, 81 patients had been followed up from 1 to 10 years (mean 3.5years) postoperatively. 61 cases were graded to be excellent and 16 eases good as assessed with Criterion of Functional Evaluation on Finger Reconstruction issued by Chinese Society of Hand Surgery. Conclusion For aesthetic reconstruction of distal finger or middle-distal finger segment, the 2nd toe is usually considered to be donor of first choice. In case the outward appearance of 2nd toe was inferior to that of 3rd or 4th toe, the 3rd or 4th toe should be chosen for better result. In some cases, revisional aesthetic surgery were necessary to refine the outward appearance in first-stage reconstruction.

Clinical application of miniature tissue transplantation in hand surgery / 中华显微外科杂志

@#Objective To explore the concept,denomination and technique of miniature tissue transplantation in hand clinic. Methods In 537 cases,local skin or composite tissue defect in 756 thumbs or fingers were repaired with 4 kinds of miniature island flap and 10 kinds of miniature vascularized composite tissue.Some of them were created in clinic practice.The precess,main points and indication of the operation were expounded and compared. Results In 639 fingers covered with miniature island flap,the transferred flaps were surviverd completely in 621 fingers(97.2%),survivered partly in 11 fingers(1.7%)and necrosised in 7 fingers(1%).In 117 fingers repaired with miniature vascularized composite tissue,all the transplanted tissues were survivered.In all the injuried fingers,beautiful outlook were recovered and no fat and clumsy were found,two-point difference was 6-8 mm,effctive sensibility and good function were restored,and all the patients were satisfied. Conclusion Miniature tissue transplantation were good methods to cover the local defect in fingers or thumbs,worth of generalization and aplication in hand clinic,and have an important significance for improve the trauma repair quality and treatment level in hand surgery.

Small size toe flap repair tissue defect of thumb and ringer / 中华显微外科杂志

Objective To explore small size toe tissue flap for aesthetic reconstruction of the thumb and / or finger. Methods Six kinds of small size toe tissue transplants had been applied in repairing skin-bone-joint composite tissue defects of the thumb or finger in 74 cases. Results Among 83reconstructed flaps of the 74 patients, 81 flaps survived completely. Follow-up examination made three to forty-eight months postoperatively showed that the outward appearance were excellent in most cases. The function of the thumbs or fingers were good. The donor feet can walk normally with no pain. Conclusion A variable combinations of toe tissues including skin, soft tissue, bone and joint can be harvested to form a lot of small size transplants for refined aesthetic reconstruction of thumb and finger. The functional and aesthetic results are good and the treatment course is shortened.

Reconstruction of long length finger: A report of 10 cases / 中华显微外科杂志

@#Objective To introduce the concept of long length finger reconstruction and our corresponding three operative methods. Methods In a series of 10 finger defect cases with one of their long finger amputated at or proximal to proximal phalanx, long finger reconstruction were accomplished with one of the three methods. First method: For emergency patients whose proximal finger segment were demolished, the donor second toe was transplanted intercalatedly with microsurgical technique between the original proximal finger stump and the saved distal finger segment. Second method: Bilateral second toes were harvested and connected together to form a long transplant in order to reconstruct a normal length finger. Third method: From one foot, the donor second toe is harvested with its dorsal and plantar skin flap. From the other foot, the second toe is harvested with its metatarsophalangeal joint and skin flaps from neighbouring sides of great and third toes. The skin covering will be perfect. During transplantation of the proximal transplant, the MPJ should be fixed at 90°plantar rotation position for better flexion. Results Uneventful survival of reconstructed fingers were obtained in all ten cases. Postoperative functional evaluation of the patients with standard set by Chinese Society of Hand Surgery showed to be excellent in 1 case, good in 5 cases and fair in 4 cases. The overall excellent/good rate was 60%. Conclusion By application of these three reconstruction methods, the challenging problem of long length finger can be solved to reasonable extent.

Discussion on the Building of Teacher Staff on Post-oriented Education in Army / 中华医学教育探索杂志

With the development of world new military revolution,the objective of education has transformed from degree-oriented to post-oriented in military university.Based on status-on-quo investigation,the author finds some deficiencies in building of teacher staff and put forward some measures.

Free pulp flap of toe in repairing thee pulp defect of finger / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate a method in repairing pulp defects of thumb and finger.</p><p><b>METHODS</b>To examine and analyze 19 case of pulp defect of thumb and finger repaired with free pulp flap of toe since 1987.</p><p><b>RESULTS</b>All the transplanted pulp flaps in 19 cases are survived and are followed up from 3 months to 12 years. All the digits recovered good out appearance with normal skin creases and ridges. The two-point discriminations are 6-8 mm. The repaired thumb or finger are free of paint during pinching and grasping. The split thickness skin grafts on the donor toes yield no hypertrophic scar and no callousity occurred on the donor feet. No detrimental influence occurred on the donor feet.</p><p><b>CONCLUSION</b>The free pulp flap transfer has obvious advantages than any other methods in repairing pulp defects of single finger by, first, good outward appearance, second, quality of the skin over donor flap is almost as rub resistant as recipient finger, third, anastomosis of the digital nerves give functional influence, finally, short rehabilitation period however, the operation requires microsurgical technique and has a risk of failure.</p>

Long- term results of vascularized fibular graft / 中华骨科杂志

Objective To analyze the long- term results of vascularized fibular graft to repair defects of long bone. Methods Nineteen patients undergone vascularized fibular graft were followed- up for 5－ 20 years(mean 10.79 years). Limb function was graded with Enneking s system, and presented as percentage of normal limb function. The changes of the vascularized fibular graft were evaluated radiographically according to the International Symposium on Limb Salvage. Results The long term results of the vascularized fibular graft varied in different types of bone defects. Nine patients with congenital pseudoarthrosis of tibia had the limb function restored in 65％ and one had nonunion of fibular graft, 3 fractures(7 times), and 5 angular deformities. Three patients with congenital radial deficiency had 62％ restoration of the limb function. All of them showed early closure of epiphyses of the grafted fibulae. Five cases with osteomyelitis and bone defects combined soft tissue deficiency had 94％ restoration of the limb function, and only one occurred fracture of fibular graft. One case with soft tissue defect and concomitant ulnar defect, ulnar nerve and median nerve injury, 67％ function of limb was recovered, and union of fibula graft was good. 100％ function of limb was recovered in 1 case with cavernoma of radius and without occurring valgus deformity of donor site. Conclusion The vascularized fibular graft is a good method for repairing long segmental defects of bone. Combined with other tissue flap, the operation can reconstruct bone defect and fulfil the cover of soft tissue. For congenital tibia pseudoarthrosis and radial deficiency, the long- term results are not so satisfactory.

Quantifying and explore the indication of digital replantation / 中华显微外科杂志

Objective To determine the factors influencing the survival rate and then quantifying the indication in digital replantation. Methods From January 1999 to November 2002,1 231 digit replantations were reviewed retrospectively.Analysis of Logistic regression was carried out between survival rate and injury degree of artery,skin,tendon,bone and nerve,mechanism of injury,severed levels,repassing duration and haemoglobin levels. Records of 50 failed and 50 succeeded fingers were selected at random and discriminant equation was made according to the factor selected by Logistic regression. Results The factors of injury degree of artery and skin,mechanism of injury,severed levedls and haemoglobin levels affected the survival rate significantly.The discriminant equation was that Z=6.42X 1+5.31X 1+4.35X 3+3.26X 4+3.15X 5. Conclusions The five factors mentioned above affect the survival rate of digital replantation.The indication of digital replantation could be quantified with the discriminant equation.

Crab-shaped hand reconstruction: bilateral second toes transfer for reconstruction of total hand or total digits defect / 中华骨科杂志

Objective To report the result of bilateral second toes transfer for reconstruction of total hand or total digits defect. Methods A series of 14 total hand or total digits defect were reconstructed by transplantation of 2nd toes from both feet forming a crab-shaped hand. Among 14 cases, 11 cases were males and 3 females. The patients were aged from 4-44 years, with an average of 22.7 years. One of the 14 cases was of congenital deformity and the other 13 were caused by trauma. The 14 cases were classified into three types according to the level of amputation; Type Ⅰ: defect at the distal end of the metacarpal bone with good function of abductor pollicis in 6 cases; Type Ⅱ: at the proximal end of carpus or the level of wrist joint in 5 cases; and type Ⅲ: at the forearm end stump in 3 cases. All the operations were successful. Results All 28 transferred toes survived uneventfully with good blood supply and pulp fullness and elasticity. Follow-up examination made at mean 6.6 years postoperative period (2-15 years) showed that mean total active motion (TAM) of IP joints of reconstructed digit was 57.5? (35?-105?). All the 14 cases had restored digital function, such as opposition of the fingers, pinching a pencil, a key, a needle or holding an ink-bottle. The mean distance between the two reconstructed digital pulps was 4.3 cm (2.6-6.5 cm). Judging by the evaluation standard of British Medical Institute, sensation recovery to S3+ was obtained in 20 digits of 10 cases. Based on the trial criteria of the function of hand reconstruction of hand surgery society of Chinese Medical Association, 2 were assessed as excellent, 7 good, 4 fair and 1 poor. Conclusion Reconstruction of crab-shaped hand for total hand or total digits defect by transfer of bilateral 2nd toes with metatarso-phalangeal joint can give the patient reasonable prehensile function without much impairment to foot function.

Reconstruction of Ⅰand Ⅱ degree defect of thumb and finger / 中华骨科杂志

Objective To describe the method and review the outcome of reconstruction ofⅠandⅡdegree defect of thumb and finger by p artial transplantation of distal to e tissue from the great and /or second toe.Methods A series of 65cases with 71ⅠandⅡdegree thumb and finger defect were r econstructed.Of those,49were thumb defect,12index finger,5middle finger and 5ring fin ger.In 6cases,two digits were reconstructed simultaneously at th e same setting.For thumb reconstruction,the donor transplants were har-vested from great toe in 14cases,fro m 2nd toe in 35cases.All finger recon struction cases were taken from2nd toe.Results Postoperative arterial crisis occu rred in 10digits and venous crisis in4.All digits survived after operative and medication trea tment.Twenty digits underwent seco ndary plastic operation for better c os-metic effect.Forty-two digits in 38cases followed-up from 6months to 13years revealed good pulp pinch function.Sensation recovery to S3 + and above in 30cases(34digits)and two-point discrimination from 6-8mm in 30digits.The patients were satisfied with the appearance of the reconstructed thumb and fingers.There were no major complication in the don or toes.Conclusion The defect of distal segment and finger tip of thumb and /or finger can be reconstru cted by transplantation of partial t issues from the great,2nd or /and 3rd toe.The operation will not be influenced by anomaly of the blood vessels.Both ultimate function and cosmetic effect can meet the patientsdesire.[

Repair of compound defect in the hand by compound or combined flap transfer / 中华显微外科杂志

Objective To introduce the outcome of compound defect in the hand treated by compound flap transfer or combined flaps transfer. Method From Dec.1983 to June 2001,thirty-five cases with five kinds of compound defect in the hand were treated surgically.Among them,four cases with defect of skin and extensor tendon in the dorsum of hand were repaired by dorsalis pedis flap with tendons;Three cases with longitudinal subtotal loss of distal thumb and one case with longitudinal subtotal loss of distal middle finger were reconstructed with fibular segmental osteo-onychocutaneous flap from great toe or tibial segmental osteo-onychocutaneous flap from second toe;Eight cases with total or subtotal defect at middle part of thumb or fingers were reconstructed with segmental second toe; seventeen cases with defect of thumb and hand skin were reconstructed with combined transplantation of second toe and free skin flap;Two cases with middle finger defect at the base of proximal phalanx were reconstructed with bridging transplantation of bilateral second toe. Result Thirty-three cases were successful.Follow-up period ranged from 0.5 to 5 years postoperatively.The excellent and good rate was 82.9% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery. Conclusion The compound flap transfer or combined flaps transfer was an ideal method in repair of compound defect in the hand.

Discussion on the Military Physician's Quality of the Future Limited High-tech War / 中国医学伦理学

Military physicians is one of the most important sections of medical service capability since they shoulder the sacred responsibility of healing the wounded and rescuing the dying and maintain and improve the fighting effectiveness of the army. The article analyses the influence of the future limited high-tech war on military medicine and the feature of military service , Based on these materials, Discussion on the military physician's quality of the future limited high tech war has been made.

Reconstruction of Thumb and Finger by Transplantation of Composite Toe Tissues: Experience in 208 Cases / 中华创伤杂志

Transplantation of composite toe tissues with microsurgical technic has boen performed in 208 patients since Oct. 1979. Among the 242 digits reconstructed, 238 digits (204 patients) were successfully reconstructed and other four digits (4 patitents) failed. The success rate was 98.3%. In this series, 135 cases were loss of thumb, 28 cases loss of fingers, and 45 cases loss of both thumb and fingers. The reconstruction procedures were composed of thumb reconstruction in 166 cases (168 thumbs), finger reconstruction in 28 cases (42 fingers) and both thumb and finger reconstruction in 14 cases (32 digits). The transplantation of second toe were performed in 188 cases and nail-skin flap of great toe transplantation were used in 18 cases. Gilbert Ⅲ variation of the first dorsal metatarsal artery was encountered in 34 donor feet in 30 patients. All these cases were successfully operated upon. A new classification system of thumb loss is proposed. The indication of various operative procedures, different ways of vascular anastomosis, the choice of emergency reconstruction, the use of graft of toe extended with dorsalis pedis flap and the pitfalls of the operation were discussed in detail.

ESOPHAGEAL RECONSTRUCTION BY VASCULARIZED FREE OR PEDICLED JEJU- NAL GRAFT: A REPORT OF 29 CASES / 解放军医学杂志

A series of 29 cases of esophageal stenosis or obstruction caused by chemical burn or malignancy in the cervical or upper thoracic segment were treated by resection, and its continuity was re-established by a vascularized free or pedicled jejunal graft. It was successful in 28 cases, with only one failure. The age of these cases ranged from 4 to 65 years old. Among them, 4 children were between 4 and 6. Sixteen cases of pedicled jejunal grafts had their vessels anastomosed to cervical vessels at the upper end. The lengths of the grafts varied from 40 to 60 cm. In the 13 free jejunal grafts, jejunal blood vessels were anastomosed to the right gastroepiploic vessels and cervical vessels at the lower and upper ends, respectively, to re-establish circulation for long jejunal segments, while for the short jejunal grafts anastomosis was made to the cervical vessels only. The vascularized jejunal patch graft is an effective measure for repairing anastomotic fistula or localized wall defect. A regime of monitoring blood circulation of the jejunal transplant is described.

EMERGENCY RECONSTRUCTION OF THUMB OR FINGER / 解放军医学杂志

Since 1970, 13 cases of reconstruction thumb and finger utilizing the second toe were performed. 13 out of 14 reconstructed digits survied with no complication. All wounds healed by primary intention. Emergency reconstruction has the following merits: it is completed in one stage, hence less suffering and economic loss to the patients;it promises early rehabilitation, early return to work and better functional results, as compared with delayed operation. Traumatic amputation of the thumb at or near the metacarpo-phalangeal joint with the transected part so badly injured that replantation is no longer fet-sible, and severe crushing injury of the thumb or all fingers are indicated for emergency reconstruction. Patient's age, occupation, desire for operation and general health should be considered individually before operation. The method of dissecting the second toe with the preservation of vasculization pattern of dorsalis pedis artery-first plantar metatarsal artery should be adopted in case the anatomic pattern of dorsal metatarsal artery belongs to Gilbert type Ⅲ.